Healthcare Provider Details

I. General information

NPI: 1710810049
Provider Name (Legal Business Name): JULIA COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NORTH CAUSEWAY BLVD, SUITE 3A, MANDEVILLE, LA 70448
MANDEVILLE LA
70448
US

IV. Provider business mailing address

350 FAIRWAY DR STE 101
DEERFIELD BEACH FL
33441-1834
US

V. Phone/Fax

Practice location:
  • Phone: 888-880-9270
  • Fax:
Mailing address:
  • Phone: 877-418-2986
  • Fax: 866-500-2186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: